Abstract
High division of the median nerve proximal to the carpal tunnel, also known as a bifid median nerve, is a rare anatomical variant with an incidence between 1 and 3%. In order to study the incidence of this anatomical variation in the Bulgarian population, we examined the upper limbs of 51 formol-carbol fixed human cadavers and also 154 upper limbs undergoing carpal tunnel decompression. We detected one case of bifid median nerve during anatomical dissections and two cases in patients with carpal tunnel syndrome. In one of the clinical cases, the anatomical variation was detected preoperatively by MRI. We discuss different variations of this nerve and emphasize their potential clinical implications.
Highlights
Well known, the bifid median nerve is a rare entity
There are reports of a split median nerve accompanied by a persistent median artery or abnormal muscles [1,2,3,4]
The bifid median nerve may be associated with carpal tunnel syndrome because of its relatively higher cross-sectional area compared with a nonbifid median nerve [4,5,6]
Summary
The bifid median nerve is a rare entity. It has been detected on anatomical specimens, on imaging studies, or during surgical interventions. There are reports of a split median nerve accompanied by a persistent median artery or abnormal muscles [1,2,3,4]. The bifid median nerve may be associated with carpal tunnel syndrome because of its relatively higher cross-sectional area compared with a nonbifid median nerve [4,5,6]. We present the incidence of a bifid median nerve in the Bulgarian population and emphasize its potential clinical importance
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